Ethan Snider, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110007078 Issued in VA

Practice address

180 Maple Ave W
Vienna, VA 22180-5727

Phone

(571) 363-3539

Fax

(571) 363-3540

NPI assigned

Aug 18, 2016

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GU, DC, VA3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 3

Specialty

Physician Assistant

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Inova Ucc LLCGroup PAC ID 7012385040, 158 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: esnider1163367@soc.inova.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Inova Ucc LLC

  • Urgent Care Clinic/Center
  • Vienna, VA
  • NPI 1508592114

  DC

  Medicare reassignment Care Compare group
• Emergency Medicine Associates P.a., P.C.

  • Emergency Medicine Physician
  • Falls Church, VA
  • NPI 1134117393

  DC

  Medicare reassignment NPD
• Emergency Medicine Associates, P.a.,P.C.

  • Internal Medicine Physician
  • Dulles, VA
  • NPI 1376917070
  Medicare reassignment
• General Conference Corp of Sda

  • Clinic/Center
  • Tamuning, GU
  • NPI 1275586877
  Medicare reassignment
• Emergency Medicine Associates P.a., P.C.

  • Internal Medicine Physician
  • Culpeper, VA
  • NPI 1881559102
  NPD
• Loudoun Medical Group, PC

  • Internal Medicine Physician
  • Leesburg, VA
  • NPI 1679591440
  NPD (past)
• Arnot Medical Services PLLC

  • Internal Medicine Physician
  • Elmira, NY
  • NPI 1427326768
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1471478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683849600000",
    "number": "1285189381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 HOWARD AVE",
            "city": "BELTSVILLE",
            "state": "MD",
            "postal_code": "207051950",
            "telephone_number": "301-312-2792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 MAPLE AVE W",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221805727",
            "telephone_number": "571-363-3539",
            "fax_number": "571-363-3540"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4801 Howard Ave",
            "address_purpose": "LOCATION",
            "city": "Beltsville",
            "state": "MD",
            "postal_code": "207051950",
            "country_code": "US",
            "telephone_number": "301-312-2792",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SNIDER",
        "first_name": "ETHAN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-18",
        "last_updated": "2023-05-12",
        "certification_date": "2023-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110007078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ethan.snider@adventistclinic.directbygreenway.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "388 Ypao Rd",
            "city": "Tamuning",
            "state": "GU",
            "country_code": "US",
            "postal_code": "969133701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Laurie J. Smith, M.S.
• Sara Smith, FNP-C
• Tara Smith
• Virginia Smith, PH.D.
• Windy Smith
• Meaghan Sniegowski
• Charles Richard Snively Jr., OD
• Melanie Sara Snyder, PA-C
• Wendy Kay Snyder, MS
• Margarita Socci

• Physician Assistant in Vienna, VA
• Providers in Vienna, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.